Microsoft word - 23679a fnl hpgst mbrs drug table_ 2011 july_smh.doc

Sarasota Memorial Hospital
July 2011
Brand Medications Requiring Use of a Generic First You can save money by using safe, effective generic medications when possible. According to your prescription benefit plan, in order for certain brand-name medications to be covered, you will have to try a generic medication first. The chart below tells you which kinds of drugs require you to use a generic first. This chart only provides a sample list of generic drug options and may not include all drugs available. Drug Class
Step 1: You wil have to try one
Step 2: Before you can try one of
ACE Inhibitors/Angiotensin II
Receptor Antagonists (ARBs)/
Direct Renin Inhibitors/
Combinations
moexipril/moexipril HCTZ quinapril/quinapril HCTZ ramipril trandolapril trandolapril-verapamil ext-rel Antihistamines/Combinations
Beta Agonists, Short Acting
Bisphosphonates/Combinations
COX-2 Inhibitors/Nonsteroidal
Anti-Inflammatory (NSAIDs)/
Combinations
HMG-CoA Reductase Inhibitors
(HMGs or Statins)/Combinations
Lescol/Lescol XL Livalo Simcor Vytorin (excluding 10 mg/80 mg)
Sarasota Memorial Hospital
July 2011
Drug Class
Step 1: You wil have to try one
Step 2: Before you can try one of
Nasal Steroids
Proton Pump Inhibitors (PPIs)
Protonix Packets Zegerid Powder for Oral Susp Selective Serotonin Agonists/
Combinations
Selective Serotonin Reuptake
Inhibitors (SSRIs)
Sleeping Agents
Urinary Antispasmodics
*This list indicates the common uses for which the drug is prescribed. Some medicines are prescribed for more than one condition. Brand-name drugs not listed here may be covered by your plan without the use of a generic first. Information provided here is not a substitute for medical advice or treatment. Discuss this information with your doctor or health care provider. CVS Caremark assumes no liability for the information provided or for any diagnosis or treatment made in reliance thereon, nor is it responsible for the reliability of the content. Subject to state law restrictions. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers that are not affiliated with CVS Caremark. Listed products are for informational purposes only and are not intended to replace the clinical judgment of the prescriber. Targeted therapeutic classes and specific drug targets are subject to change Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. 2011 Caremark. Al rights reserved. 5295-23679a v3 0711 HPGST

Source: https://gulfcoastmemberservices.org/pdf/Step%20Therapy%20Drug%20List.pdf